For services through December 31, 2026, delivery is billed with the CPT maternity codes in the 59400 to 59622 range. Each type of delivery (vaginal, cesarean, vaginal birth after cesarean (VBAC), and cesarean after an attempted VBAC) has a global code for antepartum care, delivery and postpartum care together, a delivery-only code, and a delivery-plus-postpartum code. On January 1, 2027, the CPT code set deletes those codes: antepartum and postpartum visits are then reported with E/M codes, and labor management and delivery get new codes of their own.
That change is the most important thing to plan for now. Pregnancies that start in 2026 and deliver in 2027 cross the change, and payers may not all adopt it the same way: in its CY 2027 Physician Fee Schedule proposed rule, CMS asks whether Medicare should create HCPCS G-codes that keep the current package structure instead of adopting the new CPT codes. Check each payer's policy, including your state Medicaid program and commercial plans. Payment varies by payer and locality; for Medicare, use the Physician Fee Schedule look-up.
Which delivery codes apply through 2026?
The current codes, described in our own words:
| Type of delivery | Global package (antepartum, delivery, postpartum) | Delivery only | Delivery and postpartum |
|---|---|---|---|
| Vaginal | 59400 | 59409 | 59410 |
| Cesarean | 59510 | 59514 | 59515 |
| VBAC | 59610 | 59612 | 59614 |
| Cesarean after attempted VBAC | 59618 | 59620 | 59622 |
Care that doesn't fit one package is billed in parts:
- Antepartum care only. 59425 covers four to six antepartum visits and 59426 seven or more. When a practice sees the patient fewer than four times, the visits are billed with E/M codes.
- Postpartum care only. 59430.
- Delivery only codes (above) when another practice provides the antepartum or postpartum care, for example after a transfer.
In the 2026 Medicare fee schedule, these codes carry a global indicator of MMM, meaning the usual 0, 10 or 90-day global period doesn't apply. Some of them, such as cesarean delivery, are still subject to Medicare's global surgery rules, which the surgery CPT codes guide explains.
What does the global obstetric package include?
According to the NCCI policy manual:
- The global packages include antepartum care, delivery and postpartum care.
- They don't include ultrasound, amniocentesis, special genetic screening tests, visits for conditions unrelated to the pregnancy, or additional visits for high-risk conditions. These can be billed separately when documented.
- Fetal monitoring during labor, episiotomy and delivery of the placenta are included in the delivery codes and aren't billed separately.
- Urinalysis is part of antepartum care.
- Wound repair codes aren't used to report closing a surgical incision for a maternity code.
ACOG adds that the delivery-only codes cover labor management from admission through the delivery to the postpartum orders and birth certificate, and that services at or near delivery, such as long-acting reversible contraception, are billed separately.
Which modifiers apply?
Use modifiers only when the record supports them:
- Modifier 22 (increased procedural services). Medicare's Claims Processing Manual says modifier 22 should be reported only with codes that have a 0, 10 or 90-day global period, so for Medicare it doesn't apply to the maternity codes with an MMM indicator. Other payers may allow it; check their policy.
- Visits outside the package. A visit for a condition unrelated to the pregnancy, or an additional visit for a high-risk condition, is billed with an E/M code when the record shows it. The diagnosis codes should show why the visit fell outside routine care. CPT vs ICD-10 codes explains how the two code sets fit together.
What changes on January 1, 2027?
The AMA's CPT Editorial Panel restructured the maternity care codes for the CPT 2027 code set. According to the AMA, 17 codes are deleted, 12 are added and six are revised. Care is reported in four phases:
- Antepartum care: every antepartum encounter is reported with an E/M code, under the usual E/M rules. The antepartum-only codes are deleted.
- Labor management: new codes reported once per calendar day, for the initial day and subsequent days, at two levels.
- Delivery: new delivery-only codes for vaginal delivery (with and without episiotomy), VBAC, and primary or repeat cesarean. New stand-alone codes cover repair of a third- or fourth-degree laceration or episiotomy, hysterectomy after cesarean delivery and uterine tamponade.
- Postpartum care: reported per encounter with E/M codes. Routine postpartum care on the day of delivery is part of the delivery code, and for a facility birth, subsequent hospital care codes are used for each day after delivery until discharge.
The deleted codes are 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620 and 59622. The new codes are 59080 to 59083, 59431 to 59434, 59502 to 59504 and 59623. Get the code definitions and guidelines from the AMA's published CPT 2027 maternity care file, not from summaries.
For Medicare, CMS's CY 2027 proposed rule both proposes values for the new codes and asks for comment on keeping the current structure with G-codes. The final rule is expected in November 2026.
How should practices handle pregnancies that span 2026 and 2027?
The AMA's transition guidance says antepartum visits in 2026 are reported with 59425, 59426 or E/M codes, depending on how many visits took place in 2026, and antepartum visits in 2027 are reported with E/M codes. The delivery and postpartum care in 2027 then follow the new structure. ACOG recommends that health plans start accepting E/M codes for antepartum visits, with the HCPCS modifier TH to mark them as maternity care, by September 1, 2026.
In practice:
- Identify patients due in early 2027 and track the number of antepartum visits each has in 2026.
- Bill antepartum visits as they happen, within each payer's timely filing limit, rather than holding them for a global claim that will no longer exist.
- Confirm with each payer, including Medicaid, how it will handle the change and whether it wants the TH modifier. The E/M visit level follows the same rules as any office visit; the 99214 guide explains how levels are chosen.
- Update charge masters, EHR templates and claim edits before January 1, 2027.
For billing support, see Highview's physician billing service.
Sources
- AMA, CPT 2027 Maternity Care Services code changes (updated September 17, 2026): the restructure, deleted and new codes, the four phases of care.
- AMA, CPT Education Brief: Maternity Care Services 2027, Antepartum Transition Reporting (April 24, 2026).
- ACOG, Payment for Obstetric Services: 59425 and 59426 visit counts, E/M for fewer than four visits, what delivery-only codes include, the TH modifier recommendation.
- ACOG, After Years of ACOG Advocacy, AMA Releases New Obstetric Codes (April 2026).
- Federal Register, CY 2027 Physician Fee Schedule proposed rule, 91 FR 43880–43882: valuation of the new maternity codes and the comment solicitation on HCPCS G-codes.
- CMS, Medicare NCCI Policy Manual, Chapter 7 (effective January 1, 2026), section G: what the obstetric packages include and exclude, MMM global period.
- CMS, Medicare Claims Processing Manual, Chapter 12, section 40.2.A.10: modifier 22.
- CMS, PFS Relative Value Files, RVU26D: 2026 status and global indicators of the maternity codes.
- CMS, Search the Physician Fee Schedule.